Hormones after Menopause - But Not the Ones You Might Think

Many aspects of our modern lives put us under a lot of stress -- and that can tax the capacity of our adrenal glands.  These walnut-sized glands sit on top of our kidneys, and produce hormones such as cortisol and DHEA to help us deal with stressors.  As stress becomes prolonged, our adrenals can become fatigued, leading to lower levels of these hormones.  That's why I often recommend testing of these hormones when it's necessary for the individual patient.  Along with healthy lifestyle changes, supplementation with adaptogenic herbs and nutrients can help support normal adrenal function.  If DHEA (dehydroepiadrosterone) is low, supplementing with low-dose DHEA can help to support that pathway in the body.

A recent preliminary study found that low-dose DHEA is also helpful in relieving the physical symptoms of menopause.  With concerns about some of the dangers of synthetic hormone replacement therapy (HRT), this could be a good alternative for many women, along with other supportive therapies.  It's important to keep in mind that monitoring DHEA levels is a good idea during supplementation, since this is a hormone.  

Also, using low doses (in the range of 5-15 mg per day) is the approach I recommend.  Many supplements available at stores or online contain much higher doses, ranging from 25-100 mg per capsule.  While there are specific health conditions that may benefit from the short-term use of such high doses of DHEA, it disturbs me that this is available over the counter.  When we start taking large amounts of hormones willy-nilly, whether synthetic or "natural," we're really messing with our endocrine system -- possibly with unintended consequences.

Hormone Might Ease Menopause, Boost Women's Sex Life: Study

Slash Your Risk of Breast Cancer

Last week, I wrote about weighing the risk vs. benefit for any type of preventative therapy.  A new study on breast cancer risk factors sheds some light on the best places to focus efforts for prevention.  This is important, since:

1. Women face a 1 in 8 lifetime risk of developing breast cancer, and
2. Most risk factors are controllable.

It's also important not to lose sight of the forest for the trees.  We all have limited time and energy, so focus attention on the risk factors that have the strongest evidence:

• Overweight/obesity
• Prolonged hormone replacement therapy
• Alcohol use > 1 drink per day
• Excessive radiation from medical tests (e.g., CT scans) early in life (before age 30)
• Smoking or second-hand smoke
• Night shift work
• Exposure to bisphenol A (BPA) and other plastics that act as estrogen-like compounds

Have any of these situations?  Worry about those before inconclusive risks such as cell phones or hair dye chemicals.  Also:  even though there has been a barrage of conflicting evidence in recent years, the bulk of the data comes down in favor of yearly mammograms for preventing breast cancer deaths.

The SHOCKING TRUTH about your health risks...

...is that most what you hear about them is exaggerated.  I mean, what are your risks, really?

There are a lot of claims for preventative therapies out there, both conventional and alternative.  The first step to deciding what is best for your health is to really understand the risk vs. benefit, or cost vs. benefit.

Let's say there's new nutritional supplement (or drug) that has been found to decrease your risk of a certain type of cancer by 50%.  That is a huge number, and seems like everyone should be taking it.  Why not?  Well, let's take a closer look.  That 50% is a decrease in relative risk -- meaning that the odds of getting that cancer are half of what they ordinarily would be.  So if your risk would normally be 0.2% (2 chances in a thousand), this new supplement cuts your risk to 0.1% (1 chance in a thousand).  The absolute risk reduction is only 0.1% (0.2% - 0.1%).  If this supplement costs $100 per month, it might seem worth it if you look at the 50% number.  But when you realize that you're really only decreasing your absolute risk by 0.1%, suddenly the cost seems to outweigh the benefit.

Many health conditions contain quite an element of fear.  It's important to try to look beyond this.  For example, a lot of people have a fear of flying -- no surprise, given the thought of hurtling through the air in a heavy metal cylinder 30,000 feet above the earth.  However, when you look at the risks, you are much more likely to get injured or killed in your own car than in a commercial airplane.  Similarly, some scary diseases carry a risk so close to zero, that it's just not worthwhile to invest much in prevention.

So anytime you hear SHOCKING claims about decreased health risks, ask these questions before jumping at a new preventative therapy:

• What are my odds of getting that condition in the first place?
• Are the claims based on valid research?  (I.e., good scientific method, performed by a third party rather than the manufacturer)
• Are the statistics quoted for relative risk (most of the time), or absolute risk?
• Was the research done on people who match your demographics?  (Risks are often different for men and women, different ethnic groups, etc.)
• Most importantly:  are there any simple things I can do to reduce my risk instead?
• If you're still smoking, don't bother with any supplements for cancer prevention.
• Brushing and flossing your teeth are probably more effective for heart disease prevention than antioxidant supplements.
• Reach for the fruits and veggies before the next miracle pill.
• Many of you already know what my favorite supplement is.

The more you educate yourself on risk vs. benefit, the savvier healthcare consumer you'll be.

Exercise = Longer Life

OK, so I know I go on and on about the importance of exercise.  But it's worth reinforcing, especially since our entire modern American culture is geared toward inactivity:  at work (desk jobs) or leisure (TV, computer, or other "screen" of your choice).

The latest scientific research, from the journal Circulation, found that maintaining physical fitness in mid-life decreased the chances of dying from any cause.  No surprise there -- we already know exercise is good for our health.  The difference here is that this is one of the largest studies to date to show that this protective effect of exercise held true regardless of body weight.  That's right -- if you don't lose weight, or even if you gain weight, exercise still prolongs your life.

Keep in mind that the converse is true:  if you have a normal body weight, but don't exercise, you lose that protective effect.  So if you're one of those naturally skinny people, don't think you're off the hook.

Just remember that we are biological creatures, and our bodies are designed to move!  Once again, we have evidence that movement is life, and stasis is death.

Want to live longer? Focus on fitness, not fat; Even thin people need to work out to stay healthy

It's the Hap, Happiest Season of All... Right?

This time of year brings all sorts of emotions for folks -- most warm and fuzzy, but there can also be quite a bit of sadness as well.  I heard a recent radio interview with integrative medicine expert Andrew Weil, MD, that perfectly summed up my own thoughts about depression and how to approach it.

Some highlights:

• This is a dark, cold time of year -- it's really a more natural time for introspection and "hibernation," rather than celebration.
• Sadness is OK... wow!  What a concept!  The idea that all people have to be happy at all times is peculiar to our modern American culture.  And with almost 10% of American adults on a prescription antidepressant, Big Pharma has a big interest in promoting and maintaining that idea.
• There are many natural ways to support yourself through mild to moderate depression:  
• fish oil supplements (be sure to get pharmaceutical grade)
• maintaining adequate vitamin D levels (get a blood test to check your current level)
• using mind-body techniques such as abdominal breathing, the Sedona Method, or meditation
• addressing pain through treatments such as Neurostructural Integration Technique

Be gentle with yourself, and take an accepting attitude toward all your emotions.  That's the first step toward contentment.

More Reasons to Exercise

I've often mentioned that exercise is my favorite supplement, since it has so many health benefits.  One of the most obvious benefits of exercise is weight loss, since we burn calories with exercise.  In the balance between reducing food intake and increasing exercise for weight loss, watching food portions generally gives more bang for the buck.  Why?  A half hour of moderate  exercise might burn about 200 calories or so -- an amount that could easily be cancelled out with a bag of M&Ms.

Let's not write off exercise altogether, though.  We've known that beyond just the calories burned in a single workout, exercise helps to build muscle -- which then raises our basal metabolic rate (BMR).  A higher BMR means that our body will burn more calories all day, every day -- even while sleeping!  A recent study found that regular exercise actually changes the brain, making it easier to pay attention to our body's hunger and fullness signals.  So that portion control I mentioned earlier becomes a lot easier to manage.

Want another reason to exercise?  How about improved sleep:  side effects include more energy, greater memory and concentration, and... oh, yeah!  Easier weight loss.

Too Much of a Good Thing

You've probably heard a lot (either from me or other sources) about the benefits of vitamin D:  decreased heart disease risk, better blood sugar control, decreased risk of autoimmune disease, less chronic pain and depression.... just for starters.

However, anything can have its downside, and researchers at the American Heart Association found that excess vitamin D levels can lead to greater risk of an abnormal heart rhythm called atrial fibrillation.  This is a serious condition that might precipitate heart muscle damage or clots inside the arteries and veins.

The probable cause for this is that with more vitamin D, the body can absorb more calcium.  While calcium is good for bones, too much calcium can affect nerves and muscles -- including the heart.

How much is too much according to this study?  Greater than 100 ng/ml of serum 25-hydroxyvitamin D.

This is why I recommend that nearly every patient get blood levels tested for 25-hydroxyvitamin D -- not only to check for deficiency, but also to monitor for excess.  I recommend an optimal range of 40-100 ng/ml, but based on this research, it seems prudent to bring the top end of that range down a bit to be on the safe side.

At this time of year, at any latitude north of Virginia, the sun's rays are not strong enough to produce any vitamin D in human skin.  This a good time to get your levels checked, to be sure you're set for the winter.  And if you're taking a supplement greater than 2000 IU per day, get your levels checked every 3-4 months to monitor for excess.

By the way, this article claims that 25-hydroxyvitamin D levels of 41-80 ng/ml are "far above what most doctors suggest."  This is an inaccurate statement, since every standard reference laboratory in the country puts the top end of the range between 80 and 100 ng/ml.

A caution on excess vitamin D

Ninety Percent of Americans are Missing these Disease-Fighting Powerhouses - Are You?

"What supplement can I take to replace my medication?"
This is a question I hear all the time as a doctor of naturopathic medicine.  People are often surprised when I tell them that I try to use as few pills as possible -- whether pharmaceuticals or supplements.  The foundations of health start with a healthy lifestyle:  diet, exercise, sleep, and stress management.  This is a concept that is simple, but not easy.  We've been taught that health comes in a pill, and then we can do whatever we want.

Take the one part of a healthy diet that just about all experts agree on:  eating a variety of fruits and vegetables, totaling 5-9 servings per day.  This is not exotic; no fad diet book, blood typing, metabolic typing, or anything else required.  In fact, it's so simple, that we ignore it.

Yes, 90% of Americans don't get the required amount of fruits and veggies per day.  In doing so, they miss out on not only the vitamins and minerals our cells need to function, but also hundreds of phytonutrients.  Phytonutrients are those compounds in plant foods that protect us against cancer, heart disease, and other chronic illnesses.  Ever wonder why an eggplant is purple, but a tomato is red?  No, it's not just to decorate our plates:  the variety of colors of fruits and veggies represent different phytonutrients.

No matter what your health challenges (or better yet, simply for prevention), start "eating a rainbow" each day --color your plate with at least 3 different colored fruits and veggies, and look for ways to get more servings on a regular basis.

The next time you're reaching for a medication, supplement, or the latest complex diet book, keep a food journal for a few days.  If you're not getting those 5-9 servings of fruit and veggies (mostly veggies), do that first, and see how you feel after a month.

For Nutritional Punch, You Can't Beat Plant-Based Foods

Still, 90 percent of Americans eat too few fruits and veggies, health experts say

Simple Tips for a Healthier Thanksgiving

Ah, Thanksgiving:  the holiday where we pause and reflect on what we are truly grateful for.

Okay, that took about 30 seconds... now bring on the FOOD!

On a day where food plays such a prominent role, remember that even today, moderation can make a big difference.  The easiest place to start is portion size:

• A serving of meat (such as turkey) is 3 ounces -- about the size of a deck of cards.  
• Go easy on the gravy.  
• Enjoy a few bites of dessert (yes, dessert.... even naturopaths gotta live a little, right?), but skip the seconds.
• Limit alcoholic beverages to 1 or 2 drinks.

If you're in charge of meal planning, think about simple substitutions:

• Sweet potatoes are a better source of fiber and phytonutrients than white potatoes.  Just skip the marshmallows and enjoy what nature provided!
• Ditch the white dinner rolls in favor of whole grains (100% whole wheat bread, wild rice, quinoa, etc.).

Most of all, eat slowly and mindfully.  In other words, pay attention to the food, and enjoy every bite -- you'll end up eating less that way!  Also, enjoy the company around the table -- this activates our parasympathetic nervous system, improving digestion.

Did you end up eating too much?  Try a few supplemental digestive enzymes, rather than reaching for an antacid.  Stomach acid is necessary for the proper digestion of food, and the absorption of nutrients such as calcium and vitamin B12.

Last but not least, take a little longer than 30 seconds to reflect on what you are grateful for.  Focusing on our blessings helps blessings to multiply in our lives.

Have a wonderful Thanksgiving!

Are You Being too Permissive?

In my last entry, I wrote about biology not rewarding our good intentions -- it only responds to the actual inputs of a healthy lifestyle (diet, exercise, sleep, stress management).  A particularly interesting phenomenon in this category is what psychologists call "permissiveness."

You might not have heard this term, but you're probably familiar with the scenario:  "I just did a 30-minute workout at the gym, so I'm going to reward myself on the way home with a Grande Frappuccino and muffin!"  When we do something we're not used to that's good for our health, we feel like we have more wiggle room elsewhere.  Unfortunately, this usually backfires.  Do the math:  you burned about 200 calories at the gym, and then loaded up with a 400-calorie drink.  Hey, at least you chose the apple bran muffin -- that's healthy, right?  Sorry -- at 350 calories, the 7 grams of bran fiber does not redeem this indulgence.  Bottom line?  Psychologicaly, we feel we earned that treat.  Biologically, we end up with a net gain of 550 calories that's headed straight to our fat storage.

Permissiveness is hard to avoid -- it's such a part of our human interactions, that it seems unfair that biology doesn't cut us the same slack.  What can we do?

Decide on ways to reward yourself that don't involve unhealthy behaviors such as junk food, excess alcohol, avoiding exercise, etc.  Think of big rewards like scheduling a massage, or little rewards like 10 minutes of guilt-free Farmville or Angry Birds.  Reward yourself with social interactions -- this has the added bonus of being a healthy behavior in and of itself.  (Dare I mention?  Some research has found strong social connections to be a better predictor of health outcomes than diet or execise!)

Feeling like we have to be vigilant one hundred percent of the time can be stressful and burdensome.  Seriously -- when you read a book or web site that predicts dire consequences for the slightest transgression of diet or exercise, you can be sure that the author is the only one with such strict adherence.  (And in all honesty, those authors probably aren't even that strict -- we're all human!)  So allow for treats now and then -- just keep them modest.  This acts as a safety valve, to avoid big binges down the road.

No "A" for Effort

One of the fundamental principles of naturopathic medicine is to rely on the healing power of nature, and use the gentlest form of treatment possible.  The starting point for this is always lifestyle:  a healthy diet, exercise, adequate restful sleep, and purposeful stress management.  We can debate endlessly about the best format for each of these, and how they should be applied in specific health conditions -- just browse the Internet for a few minutes, and you'll find as many opinions as there are web sites.  No matter the specifics, a healthy lifestyle has been proven over and over to result in longer life and less chronic disease.

With a background in biology, though, one conclusion I've come to is that nature doesn't give us an "A" for good intentions.  If we don't stick to these healthy lifestyle factors, we quickly become susceptible to debilitating health conditions.  Biology doesn't provide us with a pension at retirement:  "You've been a good (boy/girl) for so long, here's your gold watch -- just take it easy from now on.  Lie on the couch, have a smoke!"  I don't think so.

Have you ever broken your arm or leg?  It probably had to be in a cast for anywhere from 6-12 weeks -- and when the cast came off, that limb was significantly weaker than the opposite side.  Lack of exercise was a necessity, but it caused significant muscle atrophy in a short period of time.

A healthy diet is similar.  If you've tried to lose weight, for example, and found that you just couldn't take the pounds off, keep a diet diary for 1-2 weeks.  You could do this on paper, or through online utilities such as SparkPeople.  If you're diligent about recording everything that passes your lips, you might be surprised at how the "little" things add up:  a few M&Ms from a co-worker's desk.  Finishing up the leftovers on a spouse's or child's dinner plate.  A late-evening snack in front of the TV that's more out of habit than hunger.  We intend to follow a healthy eating pattern, but biology is unrelenting -- it counts every calorie.

If you're following an elimination diet to try to avoid foods to which you're allergic, the elimination has to be as complete as possible.  You're trying to calm down the immune system response.  Our immune system is designed to respond to the tiniest microscopic organism with a huge symptomatic response (ever been knocked flat by the flu?).  Likewise, "just a little bit" of an allergic food can keep that immune response going, leading to more symptoms.

Don't take this as all doom-and-gloom:  rather, use this information as inspiration to keep up your good habits.  For just as biology ignores good intentions, it does respond to our continued efforts.  We always have the power to make healthy choices, no matter what happened yesterday.

Rise and Shine!

Welcome back to standard time, folks... did you remember to set your clocks back this weekend?
One more question:  did you notice it was much easier to adjust to the time change this weekend than to the switch to daylight savings time in the spring?  It seems logical, since we "gained" an hour of sleep on Saturday night.  But even beyond that, this is the one weekend out of the year when the external clocks match most closely to our internal biological clocks.

Yes, we do have a biological clock -- a part of the brain called the suprachiasmatic nucleus (SCN); its job is to keep track of the daily cycle of our body's functions (also known as our circadian rhythm).  Research has shown that for most folks, the SCN is actually set to a 25-hour cycle, which means that we have to reset it every day based on cues in our environment.  That's why it's easier to stay up late, but harder to wake up earlier in the morning.

Up till about 200 years ago, our biological clocks mostly relied on the signals of sunlight to reset ourselves each day.  With the advent of reliable timekeeping, we now go by a strict 24-hour day; with electric lights, we can give in to our tendency to want to stay up later, if we choose.

Use the "extra" sleep you got this weekend to honor your body's natural circadian rhythm.  Don't complain about the early sunset, but rather use it as a signal to get to bed at a reasonable time -- and enjoy the earlier sunrise these days.  Sleep is one of the foundations of health, and most adults need around 7-8 hours per night.  Getting adequate sleep helps not only with our daytime energy, but also with preventing diabetes, cardiovascular disease, and obesity.

Weight Loss: Willpower or Biology?

"It's all about eating less, exercising more."

Obesity and overweight affect two-thirds of American adults.  You've probably heard this oversimplification of a plan to lose excess pounds, and from a basic science point of view, that's what it boils down to.  Unfortunately, the real life situation is more complicated.

I've talked to my patients for years about something called the set-point theory:  Our body has an internal regulator for body weight, kind of like the thermostat in your house.  When your house gets too cold, the thermostat turns on the furnace to warm it back up to its set point.  Likewise, our own weight "thermostat" (in the hypothalamus of the brain) drives strong hunger signals when we lose weight, to try to bring weight back up.  Recent research backs this up, with more discoveries all the time about these hormonal signals from the hypothalamus, combined with hormones from fat tissue itself -- particularly leptin.  When fat cells decrease, leptin levels fall, creating an overpowering biological drive to eat.

Is there anything we can do to fight against our own physiology?

• When you approach weight loss, do it gradually (about 1/2 - 1 pound per week) -- avoid extreme calorie restriction.
• Be conscious about portion sizes, and plan nutritious meals and snacks ahead to avoid temptation.  If hunger kicks in, at least you'll have healthy foods to choose.
• Regular exercise is key:  the ideal is 1 hour of moderate exercise, 6-7 days per week.  You can also try "burst" or interval training to kick up your metabolism.
• Get rid of the "diet" mindset, and think about lifestyle change:  adopt a long-term healthy approach to eating, including smaller portion sizes.  Plan on this to last a lifetime; don't look forward to going back to your "normal" (unhealthy) way of eating.

Losing Weight: A Battle Against Fat And Biology

Are You Tired of Feeling Tired?

Fatigue is one of the most common complaints that brings folks into the doctor’s office.  When we don’t have the energy to do what we want to do in life, it can be frustrating and depressing.  How do we get that vivacious feeling back again?

First of all, go easy on the coffee.  Drinking lots of caffeinated beverages often backfires, because it becomes less effective over time.  Also, it can disrupt your sleep patterns, just leading back to more tiredness. 

Natural “magic bullets” are often ineffective:  whether it’s 5-Hour Energy, acai berry, or whatever the newest product is this week, these promises are much more about marketing than science.  Any temporary boost they provide is likely due to placebo effect.

Focus on the basics of lifestyle first:  get some form of exercise, even if you don’t feel like it.  Over time, this will improve your energy level.  Stick to whole, natural, nutrient-rich foods.  Junk foods that are high in sugar and added fats sabotage your vitality.

One of the principles of naturopathic medicine is to find and treat the cause, not the symptom.  Fatigue can be due to any number of factors, and visiting a doctor with a holistic point of view can help provide some answers.  The most basic (and often overlooked) cause of fatigue is poor quality sleep.  This in turn may be due to anxiety, sleep apnea, shift work, or other health issues.

Some lab work can determine if there is a physiological reason for your fatigue.  Problems with the thyroid or adrenal gland are common.  Anemia affects some folks, and needs to be addressed beyond just iron supplements – there’s often an underlying cause that needs to be explored.  Blood sugar issues may be a culprit as well, whether it’s too low or too high.  Chronic fatigue syndrome is a complex disorder that often needs an individualized approach.

All of these issues can be addressed in an integrative fashion – with cooperation between conventional and natural treatments.

Get Ready for Flu Season

There’s a nip in the air, leaves are starting to change colors – which means that it’s time to start thinking about influenza.  Sore throat, fever, fatigue, muscle aches:  everyone knows it’s no fun.  The Centers for Diseases Control recommends flu vaccines for everyone, though there is no scientific evidence for this approach.  Furthermore, the flu vaccine might prevent flu virus infection, but does absolutely nothing to protect against related viruses that cause flu-like illnesses.  Are there good natural alternatives for preventing and treating the flu?

My first recommendation to everyone at this time of year is to get a blood test for vitamin D levels.  The proper test is called 25-hydroxyvitamin D, and the optimal level should be between 40 and 100 ng/ml.  Research has shown a clear connection betweenlow blood levels of vitamin D and risk of catching the flu.  Flu season can span anytime from October to May – the same time period that we don’t get enough sun exposure to produce vitamin D naturally through the skin.  Coincidence?  If you have low vitamin D levels now, it’s critical to supplement at high doses under a doctor’s supervision.  Without a blood test, a supplement of 1,000-2,000 International Units per day is advisable through the winter.

Remember good hygiene – wash hands frequently, and avoid touching your eyes, nose, and mouth.  There is no need to use antibacterial soap, since this does no better than standard soap in protecting against infection.  Get a good night’s sleep to support your immune system.  For supplemental support, look into herbs such as astragalus, larch, and elderberry, as well as extra vitamin C and zinc.  If you’re exposed to people with flu or other respiratory illnesses, use a neti pot or squeeze bottle with plain salt water to rinse the nasal passages, twice a day.

Flu vaccination is important for those with asthma and other lung problems; for nursing home residents and health care workers; and for those with suppressed immune systems.  For the rest of us, take care of yourself naturally, and if you do catch the flu, visit your naturopathic physician for specific recommendations.

The Pharmaceutical Blues

Feeling a little down in the dumps?  If you mention it to your medical doctor, perhaps you will receive a prescription for an antidepressant medication, most commonly an SSRI, such as Paxil or Lexapro.  While these medications can be very helpful in cases severe clinical depression, they are often over-prescribed these days.  Side effects are common, such as sleep disturbances and weight gain, which increase your risk for chronic diseases such as cardiovascular disease and diabetes.  In fact, a 2009 study found an 84% increased risk of diabetes for people taking antidepressant medications for 2 years or more.  This length of treatment is not uncommon; for while these drugs were originally designed to be used only for 6 weeks to 6 months, many patients find it difficult to discontinue them, and so essentially remain on the prescription forever. 

How does the naturopathic approach to depression differ?  Natural antidepressants include aerobic exercise, the herb St. John’s wort, and omega-3 fats from fish and fish oil.  Naturopathic medicine also seeks the cause of illness rather than just treating symptoms.  A thorough history, in combination with lab testing, may reveal physical issues that contribute to depression.  These can range from thyroid or adrenal problems to poor blood sugar control to menstrual cycle difficulties.  A recent animal study even suggested that probiotic supplements may improve moods.  Any of these issues is best addressed from a holistic point of view.

Looking at life circumstances is important also.  Mind-body techniques, such as meditation, Sedona Method, or Emotional Freedom Technique, can be useful to deal with everyday stressors.  A referral for counseling is often very helpful.  Sometimes, in our perfection-seeking society, we just need a reminder that sad moods are a normal and appropriate response to life’s changes and losses.

If you are at all thinking about harming yourself or others, seek urgent medical attention.  For mild to moderate depression, naturopathic care is just what the doctor ordered.

Are You Tired of Feeling Tired?

Fatigue is one of the most common complaints that brings folks into the doctor’s office.  When we don’t have the energy to do what we want to do in life, it can be frustrating and depressing.  How do we get that vivacious feeling back again?

First of all, go easy on the coffee.  Drinking lots of caffeinated beverages often backfires, because it becomes less effective over time.  Also, it can disrupt your sleep patterns, just leading back to more tiredness. 

Natural “magic bullets” are often ineffective:  whether it’s 5-Hour Energy, acai berry, or whatever the newest product is this week, these promises are much more about marketing than science.  Any temporary boost they provide is likely due to placebo effect.

Focus on the basics of lifestyle first:  get some form of exercise, even if you don’t feel like it.  Over time, this will improve your energy level.  Stick to whole, natural, nutrient-rich foods.  Junk foods that are high in sugar and added fats sabotage your vitality.

One of the principles of naturopathic medicine is to find and treat the cause, not the symptom.  Fatigue can be due to any number of factors, and visiting a doctor with a holistic point of view can help provide some answers.  The most basic (and often overlooked) cause of fatigue is poor quality sleep.  This in turn may be due to anxiety, sleep apnea, shift work, or other health issues.

Some lab work can determine if there is a physiological reason for your fatigue.  Problems with the thyroid or adrenal gland are common.  Anemia affects some folks, and needs to be addressed beyond just iron supplements – there’s often an underlying cause that needs to be explored.  Blood sugar issues may be a culprit as well, whether it’s too low or too high.  Chronic fatigue syndrome is a complex disorder that often needs an individualized approach.

All of these issues can be addressed in an integrative fashion – with cooperation between conventional and natural treatments.

Whoo! I need a cold shower.

... no, really.  It's called hydrotherapy, one of the oldest pillars of naturopathic medicine.  Hydrotherapy is simply any therapeutic use of water, and a simple practice you can adopt on a daily basis is called a contrast shower.  At the end of a normal warm shower, turn the water down to cool for about 30 seconds before turning it off.

Why on earth would you want to do that?

• This temperature contrast increases circulation to the vital organs, boosting the immune system.  A small study at Bastyr University found that contrast showers decreased the frequency of catching colds.
• Getting a cold rinse actually drives more blood flow deep to the core of the body, which keeps you warmer.  No more shivering when you step out of the shower.  (That's right -- I do this in the winter too!)
• It's a great way to wake yourself up in the morning.  It's like an adrenaline shot for your willpower.  If you can do this first thing in the morning, think of what else you can accomplish today!

As you get used to it, you can bump that final rinse colder and colder -- the more marked the temperature contrast, the greater the benefit.  If you have asthma, uncontrolled diabetes, Raynaud's disease, or any disturbance in temperature sensation, talk to your naturopathic doctor before undertaking this therapy.

Make a pledge to try this for one week -- what have you got to lose?

Come to the Urbana Sweet Corn Festival!

The Urbana Sweet Corn Festival is under way!  Come on out today (Saturday the 27th), and be sure to stop by the booth for Green Yoga Spa.  Pick up a brochure for Central Illinois Natural Health Clinic to find more information on how we can help you.

PCOS: An Emerging Women’s Health Issue

Polycystic ovarian syndrome, or PCOS, has become more common over the last couple of decades, affecting up to 12% of reproductive-age women.  The condition was named after its most prominent feature – cysts in the ovaries, which cause pain and cramping.  It is also one of the most frequent causes of female infertility.  Over time, we’ve come to understand PCOS as a complex metabolic disorder.

PCOS is not just about cysts – in fact, some women have this syndrome without actual ovarian cysts.  One of the main underlying issues is a problem with the body’s handling of blood sugar, called insulin resistance -- similar to diabetes.  This has consequences ranging from high cholesterol to weight gain.

There are also imbalances in hormones.  Women with PCOS often have higher than normal levels of male hormones, or androgens.  This can cause some of the disruptions that lead to fertility problems, as well as symptoms such as facial hair growth or acne.

The conventional approach to PCOS includes the diabetes drug metformin, and artificial hormones.  By contrast, naturopathic medicine seeks to find and treat the causes of disease rather than the symptoms.

We start with lifestyle.  It’s essential to shift from the standard American diet based on sugar and white flour to whole, natural foods.  Exercise is another key to improving insulin sensitivity.

Based on lab results, there may be specific nutritional and herbal supplements that can help support the body’s blood sugar and hormonal systems.  Vitamin D deficiency is quite common in PCOS; it’s critical to replenish vitamin D to treat this condition.

Additionally, naturopathic doctors look at the whole person, which means addressing emotional factors that are involved as well. 

This holistic approach will help not only with your PCOS symptoms, but put you on the road to lifelong optimal wellness.  With the improved fertility, that’s important, so you can be the healthiest mom you can.

Don’t Just Do Something – Sit There!

If you’ve been following my updates, you know that I’m a fan of exercise as a foundation of health, along with a healthy diet.  For a balanced life, we also need to address stress management.

Stress is an unavoidable part of life.  It’s not just unpleasant; it has very real biological effects on us.  Our bodies can’t tell the difference between being chased by a bear, or dealing with an unpleasant boss.  These modern stressors can persist for weeks, months, or years.  That can really take a toll on our health, unless we learn ways to deal with it.

When I ask most patients about what they do for relaxation, I get the expected answers:  TV, reading, video games, surfing the ‘Net.  While these can have their place, they do not really change our body’s response to the sources of stress.  Some coping mechanisms, such as smoking or excessive alcohol, are clearly even harmful for our physiology.

Is there an alternative?  Something that’s so foreign to our experience that most Americans never even consider it:  to take ourselves out of doing mode, and into being mode.  Meditation is a mindful state of awareness, without all the inputs of our overly-plugged in world.  Something as simple as sitting quietly and observing your own breathing for 5 minutes per day can literally transform your body.  Scientific studies have shown that meditation can be as helpful as medicines for conditions ranging from high blood pressure to irritable bowel syndrome.  As an active relaxation technique, meditation is not something exotic or associated with any particular religion; anyone of any belief system can learn and benefit from it.

If the idea of sitting and doing nothing is too much to handle, try a moving form of meditation, such as yoga, tai chi, or labyrinth walking.  You could even make a daily dog walk a practice in becoming aware of the present moment.

If you follow a healthy lifestyle, but still feel there’s something missing, don’t just do something – sit there!

Good night....

Sleep has long been considered by naturopathic doctors to be a foundation of health.  We all know that we can be grumpy without adequate sleep, but there's been an explosion of science in recent years that have linked poor quality sleep to everything from high blood pressure to chronic pain to obesity.  A recent article in The Seattle Times focused on the importance of maintaining a cool sleeping environment -- this is something I've told my patients for years.  In addition to this, ensure absolute darkness at night -- this helps to enhance your body's natural production of melatonin, the sleep hormone.  Shut off all screens (TV, computer, whatever electronic devices) at least 30-60 minutes before bedtime.

Insomnia plagues many in these hot months

Would you like that turkey with or without antibiotics?

The huge national recall on ground turkey in the past couple of weeks has turned the spotlight on important issues of food safety.  Not only was this turkey contaminated with the bacteria Salmonella, but many of these bacteria were resistant to common antibiotics.  How did this come about?

It is common practice in the poultry industry to administer low levels of antibiotics to birds, not because they are sick, or even to prevent infections.  It's simply to make them grow faster -- a purely economic motivation.  And the consequences are what we're facing now -- poultry potentially infected with super-bacteria that have built up a resistance to common antibiotics.  So when people contract these illnesses, we have to look farther afield for the right medicines to treat them.

One of the principles of naturopathic medicine is that prevention is better than cure.  So please practice safe food preparation techniques -- use separate knifes and cutting boards for raw poultry, and wash your hands before and after handling.  Cook thoroughly to an internal temperature of 165 degrees Fahrenheit.  Another precaution you can take is to choose organic poultry:  a new study found that these birds are much less likely to carry the resistant superbugs that are so common in conventionally-raised fowl.  Yet another reason to go organic!

Poultry raised organically is less resistant to antibiotics (Seattle Times)

Cranberry or Antibiotics for Urinary Tract Infection?

Bladder or urinary tract infection (UTI) is a problem that most women have experienced at some point in life.  For some women, UTIs recur on a regular basis.  Cranberry is an effective natural remedy at treating UTIs, and decreasing recurrence rates.  A recent Dutch study found that daily antibiotics for a year were more effective than cranberry at preventing UTIs -- sounds great, right?  Yes, until you get to the part about 85% of the bacteria becoming resistant in the group treated with antibiotics.  In other words, overuse of antibiotics produces superbugs that will just require more and stronger antibiotics down the line.

Also, as I often tell my patients, antibiotics don't just target the "bad" bugs that you don't want -- they also wipe out the beneficial bacteria that live in our gastrointestinal tract (normal flora, or probiotics).  These probiotics help to regulate our entire immune system, and they also contribute to the normal digestion of food, normal bowel movements, and the production of vitamin K.

Cranberry does not cause resistant superbugs, and it does not kill your beneficial intestinal flora.  It works by preventing the adherence of bacteria to the wall of the bladder.  So which is the better option -- daily cranberry, or daily antibiotics?  I hope that from the point of view of your total health, the choice should be obvious.  After all, if you do end up with an acute bladder infection, you can always treat it with higher dose cranberry (combined with other herbs, such as uva ursi), or even use a short-term antibiotic -- followed, of course, by 2-3 months of probiotic supplementation.

Antibiotics Beat Cranberries at Fighting Urinary Tract Infections in Study

More Muscle = Less Diabetes

Most of us know that extra body fat is not good for your health -- it tends to lead to insulin resistance, the precursor to type 2 diabetes.  Researchers at UCLA have confirmed what I've been telling my patients for a long time:  more muscle mass improves insulin sensitivity.  This is protective against diabetes.

Yet another reason that exercise is my favorite supplement.  And while cardio workouts burn more calories, which is good for decreasing fat tissue, don't forget the resistance training too.  Building up muscle can be just as important for your health.

Increasing muscle mass may lower type 2 diabetes risk

Higher potassium, lower sodium intake = longer life

A study published this month in Internal Medicine showed that those with the highest dietary potassium intake, coupled with the lowest sodium intake, had the lowest risk of dying from cardiovascular events (heart attack, stroke).  With the opposite diet (high sodium, low potassium), there is a 46% increased chance of cardiovascular death.

What this means is that we not only should be cautious about our salt intake, but also make sure we're getting plenty of potassium-rich foods, too -- namely fruits and veggies, like bananas, oranges, grapes, carrots, and leafy greens.  Keep in mind that, on average, about three-quarters of the salt in the Standard American Diet (S.A.D.) comes from processed foods (packaged foods, fast foods), not the salt shaker.  By sticking with freshly prepared whole foods, then, you take care of both lowering sodium and raising potassium in one fell swoop.  Sounds like the Mediterranean diet to me.

Once again, we can dissect out individual nutrients like this, but by focusing on whole, minimally processed foods, we usually have all the bases covered.

http://www.latimes.com/health/la-he-salt-potassium-heart-20110724,0,5730467.story

Navigating a Toxic World

In the 1967 classic movie, The Graduate, Dustin Hoffman’s character has just finished college and is seeking direction for his future career.  The unsolicited advice from a family friend?  “One word:  plastics.” 

Plastics certainly have become ubiquitous in the past forty years since those prophetic words.  Everything from water bottles to medical equipment to the cars we drive depends on them.  While this has brought many conveniences to life, it’s wise to stop and examine the consequences of all this “better living through chemistry.”

We are now exposed to tens of thousands of substances that did not exist a century ago.  It’s impossible to predict how all of these will affect our bodies’ systems, which are adapted for the natural world.

A study just published in July 2011 in Environmental Health Perspectives found that chemicals called phthalates and bisphenol A (or BPA) can harm thyroid function.  The thyroid gland is responsible for regulating our body temperature and energy levels, and thyroid problems have been increasing in recent years.  This just adds to the body of evidence about the harms of these chemicals, which are found in numerous household plastic items, food can liners, and even some toys.  What can you do to protect yourself?

In this case, the best offense is a good defense – in other words, limit your exposure as much as possible.  Avoid plastic water bottles, and even microwave popcorn (the bags are lined with harmful chemicals).  Never microwave food in plastic containers; only use ceramic or glass.  Look for BPA-free baby bottles.

Look around your house, and cut down on the number of chemicals as much as possible:  yard treatments, cleaning products, even beauty products.  Choose organic produce, meat, and eggs at the grocery store to avoid exposure to organophosphate pesticides.

Industry and regulators would argue that these chemicals are present in consumer goods in safe amounts.  While this may often be the case for individual products, what is almost never studied is the cumulative effect of this toxic soup that we now live in.  Most of these chemicals are stored for years, even decades, in our fat tissue.

If you’re concerned about the effects of such chemicals on your health, talk to a holistic physician about lab tests for your chemical levels. 

Relationship between Urinary Phthalate and Bisphenol A Concentrations and Serum Thyroid Measures in U.S. Adults and Adolescents from NHANES 2007-08

Calling all docs and nurses...

And now, some blatant self-promotion!  :-)

I will be giving a presentation:
Chiropractic Interventions in the Management of Osteoarthritis

When:  Friday, July 15 at noon
Where:  Provena United Samaritans Medical Center in Danville, in the conference rooms by the cafeteria
Why:  For great information and a free category 1 CME credit (license renewal due by the end of this month!)

See you there!

Do this to reduce your risk of dying by 92%....

One myth that I like to dispel right away with my patients is the inevitability of getting a chronic disease because of family history.  "Well, my father had heart disease, and my grandmother, so I guess I'm doomed!"  Numerous studies in the past have taken a look at the relative contribution of genetics versus lifestyle in the development of chronic disease -- and the majority of the burden has always come down on lifestyle.

This past week's issue of JAMA (Journal of the American Medical Association) had yet another amazing research study proving this point.  They looked at the risk of sudden cardiac death (SCD) in American women -- the type of fatal heart attack that comes with no warning, and in many cases no known "traditional" risk factors (like high cholesterol).  Researchers looked at this in light of four healthy lifestyle factors:  daily exercise, non-smoking, normal body weight, and high adherence to a Mediterranean-type diet.

Scoring well in even one of these categories reduced risk of SCD by 44%, compared to those who had none of the healthy lifestyle features.  But with all four healthy factors?  A whopping 92% lower risk of SCD!  This translates into lifestyle accounting for about 80% of the risk of SCD compared to genetics.  Yet another reminder that your health is largely in your own hands -- family history is not destiny.

So, anyone for a dinner that includes extra virgin olive oil, vegetables, and fish, after a quick workout at the gym?  Your life may depend on it.

Adherence to a Low-Risk, Healthy Lifestyle and Risk of Sudden Cardiac Death Among Women

With health care, do you get what you pay for?

The U.S. spends more per capita on health care than any other country in the world, yet a recent study found that we trail many other countries in terms of life expectancy.  If life expectancy is a measure of population health, then what is our money buying?  It's nice to have access to expensive, high-tech medicine like MRIs, transplants, and chemotherapy, but maybe we need to focus on the healthy lifestyle practices that prevent the need for those interventions in the first place.

 Life Expectancy in the U.S. -- CNN